Abstract
Sleep is implicated in circulating aldosterone, whereas effects of overall sleep quality are not characterized. Therefore, we explored relationship of sleep quality with plasma aldosterone concentration (PAC) in general population. We evaluated sleep quality using Pittsburgh sleep quality index (PSQI) and measured PAC in adults cross-sectionally. We divided participants into very good, fairly good, fairly bad and very bad sleepers, compared PAC and log-PAC, and applied linear regression to examine association of PSQI score with log-PAC, in total, gender- and age-stratified (young, middle-aged and old) participants. Sensitivity analysis were performed by excluding hypertension, sleep disordered breathing (SDB), or both. Among 29,499 participants, PAC showed significant increase from very good to very bad sleepers in total (14.3 vs. 14.4 vs. 14.7 vs. 15.8ng/dL), and in male participants (13.1 vs. 13.6 vs. 14.1 vs. 14.9ng/dL), consistent in the young and the middle-aged (P for all < 0.001) and in log PAC of total, in male and in different age groups (P for trend < 0.001). PSQI score showed significant positive association with log-PAC in total (B, 95%CI: 0.007, 0.003-0.010, P < 0.001) in male participants (0.013, 0.008-0.018, P < 0.001), consistent in the young and the middle-aged and in adjusted models. In female, PSQI score showed significant positive association with log-PAC in the old-aged. Sensitivity analysis yielded consistent observation with main analysis. Poor sleep quality is associated with elevated PAC, in young and middle-aged male and in elder female, independent of SDB and hypertension, indicating potential involvement of sleep quality on regulation of circulating aldosterone.